Host-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients
Abstract
Abstract Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels. In addition, transplant recipients exhibit decreased plasmablasts and transitional B cells, and increased senescent T cells. Blood and nasal transcriptional profiling demonstrate unexpected upregulation of innate immune signaling pathways and increased levels of several proinflammatory serum chemokines. Severe disease in transplant recipients, however, is characterized by a less robust induction of pro-inflammatory genes and chemokines. Together, our study reveals distinct immune features and altered viral dynamics in solid organ transplant recipients.
Article Details
Authors (382)
Joanna Schaenman
Hoang Van Phan
Alexandra Tsitsiklis
Nadine Rouphael
Nelson Iván Agudelo Higuita
Mark A. Atkinson
Scott Brakenridge
Monica Fung
William Messer
Adreanne M. Rivera
Harry Pickering
Subha Sen
David Elashoff
Dawn C. Ward
Jenny Brook
Estefania Ramires-Sanchez
Megan Llamas
Claudia Perdomo
Clara E. Magyar
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California at Los Angeles
Jennifer Fulcher
David J. Erle
Carolyn S. Calfee
Carolyn M. Hendrickson
Kirsten N. Kangelaris
Viet Nguyen
Deanna Lee
Suzanna Chak
Rajani Ghale
Ana Gonzalez
Alejandra Jauregui
Carolyn Leroux
Luz Torres Altamirano
Ahmad Sadeed Rashid
Andrew Willmore
Prescott G. Woodruff
Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Matthew F. Krummel
Sidney Carrillo
Alyssa Ward
Ravi Patel
Michael Wilson
Ravi Dandekar
Bonny Alvarenga
Jayant Rajan
Andrew W. Schroeder
Gabriela K. Fragiadakis
Eran Mick
Yanedth Sanchez Guerrero
Christina Love
Lenka Maliskova
Michael Adkisson
Aleksandra Leligdowicz
Alexander Beagle
Arjun Rao
Department of Emergency Medicine, Sydney Children’s Hospital, Randwick, NSW, Australia
Austin Sigman
Bushra Samad
Cindy Curiel
Cole Shaw
Gayelan Tietje-Ulrich
Jeff Milush
Jonathan Singer
Joshua J. Vasquez
Kevin Tang
Legna Betancourt
Lekshmi Santhosh
Logan Pierce
Maria Tecero Paz
Michael M. Matthay
Neeta Thakur
Nicklaus Rodriguez
Nicole Sutter
Norman Jones
Pratik Sinha
Priya Prasad
Raphael Lota
Sadeed Rashid
Saurabh Asthana
Sharvari Bhide
Tasha Lea
Yumiko Abe-Jones
Lauren I. R. Ehrlich
Department of Molecular Biosciences, The University of Texas at Austin
Esther Melamed
Cole Maguire
Dennis Wylie
Justin F. Rousseau
Kerin C. Hurley
Janelle N. Geltman
Nadia Siles
Jacob E. Rogers
Pablo Guaman Tipan
Arun K. Boddapati
Greg K. Tharp
Kathryn L. Pellegrini
Brandi Johnson
Bernadine Panganiban
Christopher Huerta
Evan J. Anderson
Hady Samaha
Jonathan E. Sevransky
Laurel Bristow
Elizabeth Beagle
David Cowan
Sydney Hamilton
Thomas Hodder
Amer Bechnak
Andrew Cheng
Aneesh Mehta
Caroline R. Ciric
Christine Spainhour
Erin Carter
Erin M. Scherer
Jacob Usher
Kieffer Hellmeister
Laila Hussaini
Lauren Hewitt
Nina Mcnair
Sonia Wimalasena
Jordan P. Metcalf
Nelson I. Agudelo Higuita
Lauren A. Sinko
J. Leland Booth
Douglas A. Drevets
Brent R. Brown
Scott C. Brakenridge
Ricardo F. Ungaro
Brittany Roth Manning
Lyle Moldawer
William B. Messer
Catherine L. Hough
Sarah A. R. Siegel
Peter E. Sullivan
Zhengchun Lu
Amanda E. Brunton
Matthew Strand
Zoe L. Lyski
Felicity J. Coulter
Courtney Micheletti
Scott Presnell
Bernard Kohr
Tomasz Jancsyk
Azlann Arnett
Alison D. Augustine
Steven M. Holland
Lindsey B. Rosen
Serena Lee
Tatyana Vaysman
Jing Chen
Alvin T. Kho
Carly E. Milliren
Ana C. Chang
Kerry McEnaney
Caitlin Syphurs
Precision Vaccines Program, Boston Children’s Hospital
Brenda Barton
Claudia Lentucci
Maimouna D. Murphy
Mehmet Saluvan
Tanzia Shaheen
Shanshan Liu
Marisa Albert
Arash Nemati Hayati
Robert Bryant
James Abraham
Mitchell Cooney
Meagan Karoly
Hanno Steen
Department of Pathology, Boston Children’s Hospital
Patrick van Zalm
Benoit Fatou
Kinga K. Smolen
Harvard Medical School
Arthur Viode
Simon van Haren
Meenakshi Jha
David Stevenson
Sanya Thomas
Boryana Petrova
Naama Kanarek
Ana Fernandez-Sesma
Viviana Simon
Harm van Bakel
Ana Silvia Gonzalez-Reiche
Jingjing Qi
Department of Pharmacology, Laboratory of Gene Regulation and Signal Transduction, University of California San Diego School of Medicine
Brian Lee
Juan Manuel Carreño
Gagandeep Singh
Ariel Raskin
Johnstone Tcheou
Zain Khalil
Adriana van de Guchte
Keith Farrugia
Zenab Khan
Geoffrey Kelly
Komal Srivastava
Lily Q. Eaker
Maria C. Bermúdez-González
Lubbertus C. F. Mulder
Katherine F. Beach
Miti Saksena
Deena Altman
Erna Kojic
Levy A. Sominsky
Arman Azad
Dominika Bielak
Hisaaki Kawabata
Temima Yellin
Miriam Fried
Leeba Sullivan
Sara Morris
Giulio Kleiner
Daniel Stadlbauer
Jayeeta Dutta
Hui Xie
Manishkumar Patel
Kai Nie
Brian Monahan
David A. Hafler
Ruth R. Montgomery
Department of Internal Medicine, Yale School of Medicine
Albert C. Shaw
Yale School of Medicine, New Haven, CT
Jeremy P. Gygi
Dylan Duchen
Shrikant Pawar
Anna Konstorum
Ernie Chen
Department of Neurology, Yale School of Medicine
Chris Cotsapas
Department of Neurology, Yale School of Medicine
Xiaomei Wang
State Key Laboratory of Rare Earths
Charles Dela Cruz
Akiko Iwasaki
Department of Immunobiology, Yale School of Medicine
Subhasis Mohanty
Allison Nelson
Yujiao Zhao
Shelli Farhadian
Hiromitsu Asashima
Omkar Chaudhary
Andreas Coppi
John Fournier
M. Catherine Muenker
Khadir Raddassi
Michael Rainone
William Ruff
Syim Salahuddin
Wade L. Shulz
Pavithra Vijayakumar
Haowei Wang
Esio Wunder
H. Patrick Young
Albert I. Ko
Gisela Gabernet
Denise Esserman
Yale School of Public Health
Leying Guan
Anderson Brito
Jessica Rothman
Nathan D. Grubaugh
Kexin Wang
School of Engineering and Applied Sciences
Leqi Xu
Holden Maecker
Bali Pulendran
Kari C. Nadeau
Yael Rosenberg-Hasson
Department of Microbiology and Immunology, Stanford University School of Medicine
Michael Leipold
Natalia Sigal
Angela Rogers
Andrea Fernandes
Monali Manohar
Evan Do
Iris Chang
Alexandra S. Lee
Catherine Blish
Henna Naz Din
Jonasel Roque
Linda N. Geng
Maja Artandi
Mark M. Davis
Institute of Immunity, Transplantation and Infection, Stanford University
Neera Ahuja
Samuel S. Yang
Sharon Chinthrajah
Thomas Hagan
Tyson H. Holmes
Koji Abe
Lindsey R. Baden
Kevin Mendez
Harvard Medical School
Jessica Lasky-Su
Harvard Medical School
Alexandra Tong
Rebecca Rooks
Michael Desjardins
Amy C. Sherman
Stephen R. Walsh
Xhoi Mitre
Jessica Cauley
Xiaofang Li
Key Laboratory of Cluster Science of Ministry of Education, Beijing Key Laboratory of Photoelectronic/Electrophotonic Conversion Materials, School of Chemistry and Chemical Engineering, Beijing Institute of Technology, 5 South Zhongguancun Street, Haidian District, Beijing 100081, China
Bethany Evans
Christina Montesano
Jose Humberto Licona
Jonathan Krauss
Nicholas C. Issa
Jun Bai Park Chang
Natalie Izaguirre
David B. Corry
Farrah Kheradmand
Li-Zhen Song
Ebony Nelson
Monica Kraft
Chris Bime
Jarrod Mosier
Heidi Erickson
Ron Schunk
Hiroki Kimura
Michelle Conway
Dave Francisco
Allyson Molzahn
Connie Cathleen Wilson
Trina Hughes
Bianca Sierra
Jordan Oberhaus
Faheem W. Guirgis
Brittney Borresen
Matthew L. Anderson
Bjoern Peters
Randi Vita
Kerstin Westendorf
Scott J. Tebbutt
Casey P. Shannon
Rafick-Pierre Sekaly
Slim Fourati
Grace A. McComsey
Paul Harris
Scott Sieg
George Yendewa
Mary Consolo
Heather Tribout
Susan Pereira Ribeiro
Charles B. Cairns
Elias K. Haddad
Michele A. Kutzler
Mariana Bernui
Gina Cusimano
Jennifer Connors
Kyra Woloszczuk
David Joyner
Carolyn Edwards
Edward Lee
Edward Lin
Nataliya Melnyk
Debra L. Powell
James N. Kim
I. Michael Goonewardene
Brent Simmons
Cecilia M. Smith
Mark Martens
Brett Croen
Nicholas C. Semenza
Mathew R. Bell
Sara Furukawa
Renee McLin
George P. Tegos
Brandon Rogowski
Nathan Mege
Kristen Ulring
Pam Schearer
Judie Sheidy
Crystal Nagle
James A. Overton
Scott R. Hutton
Greg Michelotti
Kari Wong
Adeeb Rahman
Vicki Seyfert-Margolis
Ramin Salehi-Rad
Matthew C. Altman
Patrice M. Becker
Steven E. Bosinger
Department of Pathology & Laboratory Medicine, Emory University, Division of Microbiology and Immunology, Emory National Primate Research Center
Walter Eckalbar
Annmarie Hoch
Naresh Doni Jayavelu
Seunghee Kim-Schulze
Meagan Jenkins
Steven H. Kleinstein
Department of Pathology, Yale School of Medicine
Florian Krammer
Holden T. Maecker
Department of Microbiology and Immunology, Stanford University School of Medicine
Al Ozonoff
Joann Diray-Arce
Harvard Medical School
Albert Shaw
Lindsey Baden
Ofer Levy
Harvard Medical School
Elaine F. Reed
Charles R. Langelier